Geographic proximity to treatment for early stage breast cancer and likelihood of mastectomy

被引：72

作者：

Boscoe, Francis P. ^{[1
]}

Johnson, Christopher J. ^{[2
]}

Henry, Kevin A. ^{[3
]}

Goldberg, Daniel W. ^{[4
]}

Shahabi, Kaveh ^{[5
]}

Elkin, Elena B. ^{[6
]}

Ballas, Leslie K. ^{[7
]}

Cockburn, Myles ^{[8
]}

机构：

[1] New York State Canc Registry, Menands, NY 12204 USA

[2] Canc Data Registry Idaho, Boise, ID USA

[3] New Jersey State Canc Registry, Canc Inst New Jersey, New Brunswick, NJ USA

[4] Univ So Calif, Spatial Sci Inst, Los Angeles, CA USA

[5] Univ So Calif, Dept Comp Sci, Los Angeles, CA 90089 USA

[6] Mem Sloan Kettering Canc Ctr, New York, NY 10021 USA

[7] Univ Texas MD Anderson Canc Ctr, Dept Radiat Oncol, Houston, TX 77030 USA

[8] Univ So Calif, Dept Prevent Med, Los Angeles, CA 90089 USA

来源：

BREAST | 2011年 / 20卷 / 04期

关键词：

Health services accessibility; Breast conserving surgery mastectomy; Choice behavior; Geography; 20-YEAR FOLLOW-UP; RADIATION-THERAPY; HOSPITAL CHOICE; TRAVEL DISTANCE; PATIENTS BYPASS; RATES; PATIENT; RADIOTHERAPY; IRRADIATION; FACILITIES;

D O I：

10.1016/j.breast.2011.02.020

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Purpose: Women with early stage breast cancer who live far from a radiation therapy facility may be more likely to opt for mastectomy over breast conserving surgery (BCS). The geographic dimensions of this relationship deserve further scrutiny. Methods: For over 100,000 breast cancer patients in 10 states who received either mastectomy or BCS, a newly-developed software tool was used to calculate the shortest travel distance to the location of surgery and to the nearest radiation treatment center. The likelihood of receipt of mastectomy was modeled as a function of these distance measures and other demographic variables using multilevel logistic regression. Results: Women traveling over 75 km for treatment are about 1.4 times more likely to receive a mastectomy than those traveling under 15 km. Conclusions: Geographic barriers to optimal breast cancer treatment remain a valid concern, though most women traveling long distances to receive mastectomies are doing so after bypassing local options. (C) 2011 Elsevier Ltd. All rights reserved.

引用

页码：324 / 328

页数：5

共 38 条

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